﻿@{
    ViewBag.Title = "Registrar";    
}

@if (ViewBag.flagExito)
{
  
           
<div id="modalbox" style="display: block;">
	<div class="devoops-modal">
		<div class="devoops-modal-header">
			<div class="modal-header-name">
				<span>Mensaje</span>
			</div>
			<div class="box-icons">
				<a class="close-link">
					<i class="fa fa-times"></i>
				</a>
			</div>
		</div>
		<div class="devoops-modal-inner"><div class="form-group"><span>Se ha registrado el paciente correctamente y su clave ha sido enviada al correo.</span></div></div>
		<div class="devoops-modal-bottom"><div class="text-center"><a class="btn btn-primary" href='@Url.Action("index","paciente")'>Ok</a></div></div>
	</div>
</div>
}

<div class="row">
	<div id="breadcrumb" class="col-xs-12">
		<a href="#" class="show-sidebar">
			<i class="fa fa-bars"></i>
		</a>
		<ol class="breadcrumb pull-left">
			<li><a href="index.html">Dashboard</a></li>
			<li><a href="#">Forms</a></li>
			<li><a href="#">Forms layouts</a></li>
		</ol>
		<div id="social" class="pull-right">
			<a href="#"><i class="fa fa-google-plus"></i></a>
			<a href="#"><i class="fa fa-facebook"></i></a>
			<a href="#"><i class="fa fa-twitter"></i></a>
			<a href="#"><i class="fa fa-linkedin"></i></a>
			<a href="#"><i class="fa fa-youtube"></i></a>
		</div>
	</div>
</div>
<div class="row">
	<div class="col-xs-12 col-sm-12">
		<div class="box">
			<div class="box-header">
				<div class="box-name">
					<i class="fa fa-search"></i>
					<span>Formulario de Registro</span>
				</div>
				<div class="box-icons">
					<a class="collapse-link">
						<i class="fa fa-chevron-up"></i>
					</a>
					<a class="expand-link">
						<i class="fa fa-expand"></i>
					</a>
					<a class="close-link">
						<i class="fa fa-times"></i>
					</a>
				</div>
				<div class="no-move"></div>
			</div>
			<div class="box-content">
				<h4 class="page-header">Registrar Nuevo Paciente</h4>
				@using (Html.BeginForm("registrar", "paciente", FormMethod.Post, new { id = "frmRegistroPaciente", @class = "form-horizontal", role = "form" }))
    {
					<div class="form-group">
						<label class="col-sm-2 control-label">Nombre</label>
						<div class="col-sm-4">
							<input type="text" class="form-control" placeholder="First name" data-toggle="tooltip" data-placement="bottom" title="Tooltip for name">
						</div>
						<label class="col-sm-2 control-label">Apellido Paterno</label>
						<div class="col-sm-4">
							<input type="text" class="form-control" placeholder="Last name" data-toggle="tooltip" data-placement="bottom" title="Tooltip for last name">
						</div>
					</div>
                    
                    <div class="form-group">
						<label class="col-sm-2 control-label">Apellido Materno</label>
						<div class="col-sm-4">
							<input type="text" class="form-control" placeholder="First name" data-toggle="tooltip" data-placement="bottom" title="Tooltip for name">
						</div>
						<label class="col-sm-2 control-label">Sexo</label>
						<div class="col-sm-4">
							<input type="text" class="form-control" placeholder="Last name" data-toggle="tooltip" data-placement="bottom" title="Tooltip for last name">
						</div>
					</div>
                        <div class="form-group">
						<label class="col-sm-2 control-label">Tipo de Documento</label>
						<div class="col-sm-4">
							<input type="text" class="form-control" placeholder="First name" data-toggle="tooltip" data-placement="bottom" title="Tooltip for name">
						</div>
						<label class="col-sm-2 control-label">Numero de Documento</label>
						<div class="col-sm-4">
							<input type="text" class="form-control" placeholder="Last name" data-toggle="tooltip" data-placement="bottom" title="Tooltip for last name">
						</div>
					</div>
                    	<div class="form-group">
						<label class="col-sm-2 control-label">Correo</label>
						<div class="col-sm-2">
							<input type="text" class="form-control" placeholder="City">
							<span class="fa fa-key txt-warning form-control-feedback"></span>
						</div>
						<div class="col-sm-2">
							<input type="text" class="form-control" placeholder="Country">
							<span class="fa fa-frown-o txt-danger form-control-feedback"></span>
						</div>
						<label class="col-sm-2 control-label">Direccion</label>
						<div class="col-sm-4">
							<input type="text" class="form-control" placeholder="Another info" data-toggle="tooltip" data-placement="top" title="Hello world!">
						</div>					
					</div>
                             <div class="form-group has-feedback">
						<label class="col-sm-2 control-label">Teléfono</label>
						<div class="col-sm-4">
							<input type="text" class="form-control" placeholder="First name" data-toggle="tooltip" data-placement="bottom" title="Tooltip for name">
						</div>
					<label class="col-sm-2 control-label">Fecha de Nacimiento</label>
						<div class="col-sm-4">
							<input type="text" id="input_date" class="form-control" placeholder="Date">
							<span class="fa fa-calendar txt-danger form-control-feedback"></span>
						</div>
					</div>


					<div class="clearfix"></div>
					<div class="form-group">	
                    <div class="col-sm-11">
							
						</div>				
						<div class="col-sm-1">
							<button type="submit" class="btn btn-primary btn-label-left" >
							<span><i class="fa fa-clock-o"></i></span>
							    Grabar
							</button>
						</div>
					</div>
    }
			</div>
		</div>
	</div>
</div>


        
        
<script type="text/javascript">
    $(document).on('ready', function () {
        $('#input_date').datepicker({ setDate: new Date() });
    });

    $('#btnGrabar').on('click', function () {
        window.location.href = '@Url.Action("index", "paciente")';
    });
</script>

        
    



